What I Did in March '24 -- Susan Price

What did I do in March?

I was smitten, hip and eye.

 The Hip

I'd had severe arthritis in my left hip for two or three years. I used to go to the gym and I loved walking in the countryside, but the pain was so bad, I became pretty much house-bound.

My partner and friends nagged me to ask for a referral to a consultant, and after the usual delay (thank you so much, Tories), I finally saw a Trauma and Orthopaedic consultant in December '23.  He glanced at my x-ray and said simply, "That hip joint is utterly destroyed. The only possible treatment here is a total hip replacement."

 

I was placed on the waiting list. Friends and family immediately ganged up on me again. My younger brother and sis-in-law work within the NHS and know its little ways. My Scots partner has always been one for striding to the front and insisting (politely but very firmly, in that brogue which the English often seem to find scary) on being heard.

Then there were the members of Flatcap (who know who they are): a group of writer friends, who keep in regular touch by email and zoom.

You must shout, they all said. Get yourself put on the short-notice cancellation list. Write to PALS, the Patients' Liaison Service. (Is there a word more difficult to spell than 'liaison'? It just makes no sense.)

I did it all, mainly to silence the nagging. Personally, I didn't think it would make any difference to my waiting time, especially after fourteen years of deliberate Tory dismantling and underfunding.

PALS were sympathetic, but had to deliver back to me a pretty short reply from the Trust  managing my local hospitals, Sandwell General and City Road. You're on a long waiting list, said the Trust. So you'll have to wait. That's what you do on a waiting list. There is no chance of a hip replacement until May at least, more likely June.

So I gritted my teeth and, took more co-codemol.

Then, on the Friday, 8th March, about 11am, the phone rang. I didn't recognise the number and didn't feel in the mood for insulting a cold caller, so nearly didn't answer it. But I thought: What the hell, live dangerously. I took the stranger's call.

A cheery young woman on the other end cried, "Can you get to City Hospital by 3pm today? If you can, there's been a hip-replacement cancelled on the 13th, and you can have it, if you can get the preliminary checks done this afternoon."

I snatched a breath and said, "I'll be at City by three if I have to crawl there!"

Taken from Amazon; follow link for page

Luckily, there was a taxi available. And when it came to the long, painful hikes across entrance halls, up stairs and along miles and miles of corridor, I had my elbow crutches with the big, paw-like feet which, supposedly, makes them able to stand upright by themselves. Although, like all crutches, there is nothing they like better than crashing noisily to the floor and then lying there, to trip passers-by.

Still, I was able to make the nurses laugh by standing the crutches by my chair, pointing at them and saying sternly, "Stay." For once, they did.

The preliminaries included blood tests (as usual), height and weight measurements, blood-pressure readings and heart checks. I was told that my op would be first on that day's list. ("Good," said my NHS brother, whose job that week happened to be booking hip-replacement ops in and out. "First up. They won't be able to give you any of that 'run out of time' malarkey." 

I had to be at Sandwell Hospital at 7-30am and would be staying 'at least overnight.' So, I booked a taxi and made sure of the important things by fully charging up my Kindle.

 The Eye

 Two days before the op, on Monday 11th March, I walked through the doorway of my living room and, on the threshold, something happened to my left eye.

In the hall, sight was fine. As I stepped into the brighter light of the main room, my left eye became full of broad black and white zig-zags, like 1960s op-art. To the right of the left eye was a black patch; to the left was a crumpled up version of my room.

Very odd. However, there was no pain. Back in 2020, I'd had the lenses in my very short-sighted eyes replaced by artificial ones. I concluded that the artificial lens in the left eye had become dislodged. I was reluctant to head off to the Eye Hospital, or even my optician, in case eye treatment interfered with the hip replacement. (The hip was bloody painful, all the time.) I still had good sight in the right eye. The left eye, I reckoned, could wait for its lens to be nudged back into place.

The Orthopaedic surgeon phoned me to check that I was still on for the hip replacement. I told him about the eye. "Is it at all red or irritated?" he asked. (If there's a site of infection anywhere in the body, the infection can be carried in the blood to the surgical incision and the artificial joint. This then entails heavy doses of antibiotics, at least, with all their side-effects, and if they don't work, another operation to remove the infected hip replacement. Obviously, surgeons try to avoid this at all costs. Patients are asked to get their teeth checked before surgery and any sources of infection in the mouth made good.)

I was able to say, honestly, that no, the eye felt fine. I just couldn't see very much out of it that made any sense. "If there's no irritation," he said, "I'm perfectly happy to go ahead with the operation. We'll see you here at seven-thirty am, you'll be in theatre by eight and back on the ward by about eleven."

Sandwell General

So off I went, early on the morning of Wednesday March 13th, in a taxi, with a small suitcase. And the nurses barely had time to call me 'sweetheart' before I was in one of those bizarre hospital gowns (what is the point of them?) and on a trolley, being wheeled along corridors with those square ceiling lights passing above, just as in every medical drama ever filmed.

I'd been told that I'd be given an epidural to numb me below the waist, but that I'd be awake above that. I expected to be totally numb from the waist down and wide awake and paying attention above, but it didn't turn out much like that...

I'd been puzzled about how I would lie on the table. On my back? Awkward for getting at the hip. On my right side? But wouldn't I topple over? -- Turned out I was wedged into position on my side with scaffolding.

The epidural felt like having very shaggy, furry trousers on inside out. A sort of tickly, softly scratching and buzzing sensation outlining the legs. I couldn't move them, but was surprised that I could feel the surgeons grasping my ankle and lifting my leg up. The anaesthetist, a solid and comforting figure standing close beside my head as I lay on the table, said, "Yes, you'll feel touch, but there'll be no pain sensation." She was as good as her word.

In fact, the worst pain I felt from start to finish of the hip-op, was the inserting of a canula in the back of my left hand, through which various drugs were injected. It was agony every time it was touched. In fact, the site was still quite painful three weeks later, if I happened to touch the back of my hand (though it's finally healed now, thank goodness).

The anaesthetist noticed. In the middle of the op, she put her hands on her hips and demanded loudly, "Who put this canula in? Who did that? Every time I inject her, she jumps with pain!" Too bloody right. I meanly hope somebody got a right telling off.

Meanwhile, lying on the table, though not fully unconscious, I was close to it, very drowsy and out of it. I drifted off somewhere after the canula exclamation, but drifted back a little on hearing tremendous thumping and banging. I was lying in bed at home and someone was battering on the front door downstairs. They were using both fists or maybe even a battering ram or sledge-hammers. Who on earth was making such an uproar, and why? Was there a fire? Not that I felt too bothered.

In mild curiosity, I lifted the sheet over my face and, to my astonishment, saw a woman in a dark blue uniform standing by my bed. 'What is she doing in my house?' I thought, indignantly. 'How did she get into my bedroom?' -- And then, as the frenetic hammering continued, I thought: 'Oh!'

Obviously, we'd gone beyond the incision and the sawing out of viciously gnarled arthritic bone (without me being aware of any of it), and had progressed to the 'hammering into place of artificial joint.' But all I was aware of was noise. There was absolutely no pain and, as far as I can remember, no feeling of those hammers making touch-down, but the surgeons were going at it like blacksmiths.

I was back on the ward, with tea, biscuits and toast, by 11-30. I don't remember feeling much pain at all. It turned out that, since I'd been deemed relatively fit and healthy, I'd been put on the 'fast-track recovery path,' which meant that I was supposed to spend no more than 43 hours in hospital. Indeed, I was walking around the ward in the afternoon after the op. Using crutches, but then I'd been using crutches to keep weight off my bad hip for years.

The surgeon came to see me, and told me that the removed hip had been 'very bad indeed' but that he and his team were completely happy with the results of the op.

Most people complain about their stay in hospital: the food is bad, the wards are noisy, they get no sleep, etc... Well, I was in so short a time, I don't know if I'm really qualified to speak. I slept very well, better than I had for ages, but then, without hip pain, I could sleep on a washing line. The food was perfectly fine, especially if you've had hardly anything to eat all day, and your body is seeking round urgently for protein to make repairs. I have no complaints about it at all.

And the nurses were the busiest, kindest, most impressive people I think I've met. Always rushing about on some job, yet never forgetting that thing they promised to fetch or do for you. I don't think I've ever been called, 'Sweetheart, darling, babs, chook, chick, dearie, honey, lambkin, lamb, lambie, sugar, sugar-pop, sweetie, sweetie-pie, honey-drop and treasure,' so many times in so few hours.

In fact, until that hospital stay, I'd never been called most of those things. When I told my Flatcap writer friends, they volunteered to call me by every name on this list every time they saw me, if I liked, but, y'know... that's okay, you needn't bother.

My departure was delayed until mid-afternoon on the 14th, due to a delay in the pharmacy getting my medication together, and this annoyed the nurses a little. I gather they were quite invested in the '43 hours fast-track' experiment, and maybe it meant the next patient couldn't be admitted until I left.

Anyway, off I went home in a taxi, with a long list of things I must not do. The NHS had already delivered a big square chair for me to sit enthroned, rather than sit on my soft, low sofas, because one of the 'must-nots' was to not bend the hip at more than a ninety-degree angle or to sit with knees higher than hips. No low seats, or bending low to pick things up, no sitting with knees higher than hips.

Extremely useful litter picker: Amazon

I'd been instructed to buy for myself a long handled shoehorn and what I call 'a grabby stick' but which seems to be officially called 'a litter picker' to help me pick things up from the floor without bending. (And it's a really useful bit of kit, whether or not you have hip trouble. There's always something that's fallen down into an awkward space between furniture, or is up  on a high shelf... I wish I'd got one years ago.)

I must not forget to do the exercises to fend off blood clots, nor forget to take the blood-thinner tablets. I must wear the surgical stockings day and night. Must not drive, must sleep on back, must keep up the fluids, must not sit for long periods, must walk further ever day...

The Eye

Not only could I not drive, I wasn't supposed to be a passenger in a car for a few days, so I put up with the dodgy eye for a bit longer. Then I went to my optician, by taxi. My brother, the excellent egg, came with me, "so I can pick you up if you fall over." (Reader, I didn't).

I expected the optician to do a quick examination and then refer me back to the clinic that had replaced the lenses in my eyes, but from the first there was a strained sort of atmosphere. The head optician hung about as her junior did the eye-tests, and twice she asked for a test to be repeated.

Then she took me into another room and told me she was going to write a referral letter, which I was to take with me, directly, to the eye-hospital. "What, now?" I said. It was about four on a Friday afternoon.

Yes, now, said the optician, immediately. I had a torn retina, the worst sort of tear, right across the macula, or middle of the eye. It should have been seen immediately, as an emergency, but I had delayed ten days -- so, yes, now, immediately, this minute, straight into a taxi, do not pass go.

Birmingham and Midland Eye Centre, City Road

So the brother and I went off to the Eye Hospital, where we waited from about 4-30pm to midnight, the waiting-room crowd dwindling about us as the hours passed, until there was just us and a couple of others sitting in a cold, half-lit room. The poor brother didn't even have his kindle with him.

I finally saw 'the night doctor,' who came on duty at 8pm, but first had to help in A&E until it closed. It was after 11pm before I saw her, when she repeated all the tests the optician had done, and told me that 'in seven to ten days' I would hear from the hospital. So, a taxi home. I have spent a fortune on taxis recently. 

That was on Thursday 21st March, about a week after the hip op. I certainly got the required exercise by hiking around the hospital.

On the morning of Saturday 23rd, the phone rang. There was an eye-surgeon on the other end, who said, "If you can get here within forty minutes to an hour, we'll do the op."

I phoned a friend. It was a toss-up whether a lift from him or another taxi would be quicker. Davy took me in, and waited around, to drive me home afterwards.

Wiki-commons: eye under operation

How do you feel about having your eye injected? And cut open? I have previously felt that I would sprint  screaming down corridors and jump through second storey windows to escape from it-- yet I lay there quite calmly. At first, anyway.

Despite the anaesthetic injections, it was much more painful than the hip op. The surgeon kept saying, "You'll feel a little pressure now." What he meant was, "This is going to bloody hurt." (And throughout, he leaned heavily with one hand on my good eyeball.)

I hate to think what it would have been like without the pain-killing injections.

A male nurse seated himself on a stool beside me, took my hand in his own big, warm, hand and said, "You can squeeze my fingers as hard as you like." So they knew it hurt. And was scary. Whoever he was, I was glad of his presence and glad to have his hand to squeeze.

The surgeon chatted to his nurse: "Pass me the laser now... Give me the cutter... I want the twelve-gauge needle... What is the pressure?"

He also answered several phone-calls, usually fielded by the male nurse (who had to let go of my hand while he answered the phone.) The calls were about other operations. The surgeon agreed to do another the next day, Sunday, but put off another. "I'm not doing two tomorrow." Others, he suggested might be done by others. Eye surgeons are obviously in hot demand. (Or is it just that the Tories have ensured there aren't enough of them?)

Meanwhile, my op continued. My right, sighted eye was covered. Through the damaged, left eye I could see a circle of a beautiful pale, golden orange. Across this circle, a long, whiskery probe kept appearing and poking at the circle's edges. This poking hurt, along a spectrum from 'slight pin-prick' to 'bloody ouch!' -- I have no idea if all eye operations hurt like this, or if, because it was an emergency, on-the-spur-of-the-moment op, the pain-killers hadn't been allowed to work to their fullest. Though the presence of the hand-holding male nurse suggests that all eye-ops hurt that much. (Do male patients get a female hand-holder?)

I was telling a group of friends about watching the probe poking about inside my eye. I glanced up and saw one of them listening with both hands clamped over her mouth and her own eyes wide in horror.

I really don't want to put my friend or anyone else off eye surgery if they need it. And, honestly, the canula in the back of my hand hurt far more, whenever it was touched or moved, than anything in the whole of the eye-op. On that old Pain-Scale of 0-10, I think the canula was up there at 8, with regular bursts of pure pain, while the poking and 'pressure' of the eye-op never rose that high (though it certainly nipped and stung). But the very fact that you're watching somebody poking about in your eye raises your fear and expectation of pain. I kept trying to relax, remembering that relaxing reduces pain -- but it was hard.

During the hip-op, the surgeons sliced open my hip, sawed through and removed the top of my femur, (I heard the saw buzz), and then energetically whacked a new ball-joint into place, and stitched the cut muscles back together -- and I never felt the slightest pain from any of this. There was a lot of swelling and bruising later, that I had to take painkillers for, but during the op, nothing.

But perhaps the nature of eye pain and hip-joint pain is like that. I don't know.

I know that the eye op seemed to go on endlessly, on and on in a half-darkened room. Everytime I felt-- hoped-- that it might be finishing, another stage started. I began to be desperate for it to end. Occasionally the hand-holder would murmur, "Not so long now..."

"These bubbles," said the surgeon. "They're in my way. Burst them, just burst them! -- The lens needs cleaning before it's put back..."

Since the retina is right at the back of the eye, I suppose the artificial lens had to be removed from its retaining capsule before the retina could be repaired. Perhaps real, biological lenses do too. But this is just my guess.

 "It won't fit," said the surgeon, "it won't fit in the capsule..."

I could feel him, tussling to force the lens back into the capsule that holds it. (Please, please let this end.)

I had intended to politely thank everyone for their incredible work but, by the end, I was too shattered to speak. I was limp. I had to spend ages in 'recovery' because my blood pressure was so high. Nurses gave me drinks, called me Babs and Sweetie, repeatedly took my temperature and blood pressure and eventually released me, with my interesting eye-dressing, to the waiting room.

By then, it was dark, and Davy told me he'd been waiting for nearly four hours. 

The next day, at home, I got up and sat in my special, NHS 'hip-op' chair, As I sat there, enthroned, I suddenly found myself shaking hard with chattering teeth, for several minutes. I couldn't stop. I wasn't cold. I can only think it was delayed shock.

I forgot to mention that I have a gas bubble in my eye.

This isn't a mistake or accident. The bubble was placed there by the surgeon, to put pressure on the repair and help it heal. For the first day and night after the surgery, I had to keep my head down and sleep face down. I had to lie across my bed, with my head hanging over one side and my forehead supported on a chair-seat and cushions. Again, thanks for the invention of the Kindle, which I could place on the floor and read.

After that one night, I had to spend the next seven days-- seven days -- lying down 'with right cheek on pillow' for 45m out of every hour. Without the Kindle and the Falco books, I would never have made it.

I gather that some people have to spend weeks like this. You can actually hire 'macular posturing stools' which you kneel in. There's a frame to hold your head, a place to put a book, and mirrors arranged so you can watch tv or talk to people. Who knew?

Macular posturing stools - a selection. Follow link for more!

The gas bubble, I'm told, will dissipate by itself. It already has shrunk. I can now see its edge wibbling and wobbling across what remains of vision in the left eye. Although still very blurred, vision in the damaged eye has steadily improved, day by day, from almost total blindness to seeing blurred blocks of light (windows) and blurred blocks of sofas and shelves.

I was in a friend's bathroom recently, where the white tiles and white bath bounced a great deal of light around, and, peering around the gas bubble, the left eye could see the taps and the plug-hole very clearly, though slightly blurred at the edges. On returning to the main room, though, where the light level was lower and the decor darker, everything was much less clear. My friend was a slightly flesh-toned blob on the dark blurry block of his sofa.

I was warned not to have high expectations of the retina repair. The operation should have been done as an emergency, on the day it happened. But, not realising how serious it was, I delayed for ten days. As a result, the eye surgeon said, the retina had become completely detached, floating free. -- So I feel that to have some sight in the eye, even very blurred, is something I'm grateful for.

Looks like I'll be wearing specs again.

April update: The operated eye is now like a glass jar or cup, half-full of water. If I close my good eye, I can see the water bobbing up and down with a gentle wave every time I move my head. Above the water-line, vision is quite good, in strong light. Blurred in weaker light -- and also blurred by the water, I think. This water will be absorbed by my body, or drain away over the next month or so.

How do you adequately thank the teams who did these operations?

I feel I ought to thank them, but I don't know how to start. Their skill, their long-term dedication to acquiring that skill, their hours and hours of patient, knowledgeable work... The surgeons, of course, but also their teams of highly skilled anaesthetists, juniors and nurses.

The Ant and the Opera

I've always been pro-NHS, but I was nevertheless amazed and impressed by the way this immense organisation swung into action when I needed it, despite all the damage the Tories have dedicated themselves to inflicting on it.

I said to a nurse that I felt like an ant caught up in an opera and she looked at me quizzically. Perhaps she thought I'd had too strong a dose of medication. Maybe I had, but...

In a well organised, directed opera, the orchestra is rehearsed and strikes up in unison, exactly on cue: and then plays complex music perfectly. The chorus sweeps on and does its stuff and shuts up exactly as needed when the divas launch into their arias... In a trice, scenery and props are removed and replaced, spotlights move as needed, and everything and everyone involved in this complicated production whirls in and out of place and powers on. Given a good night, no cues are missed or, if they are, they're caught in time without the audience noticing.

And there was I, one insignificant ant with a dodgy hip-joint and a dodgy eye -- the scene-changers swept in, swept me up, changed the set around me... On swept the chorus and the divas, the orchestra hit all the right notes, right on time -- and it all rushed on to the last scene, where I sat bemused in a recovery room or ward with something of the feeling of 'What the Hell just happened?'

How do you say thanks for that?  I don't suppose the surgical teams need another card or box of chocolates, not even expensive cards or chocolates.

Inside a month, I've just had an 'utterly destroyed' hip joint replaced, and a torn retina repaired, 'completely free of charge at point of use.' I've paid towards the cost of these operations over the whole of my working life, in taxes -- but never noticed the cost.

If I'd had to pay for the cost of these operations privately, I doubt I could have afforded it. The hip operation would have cost at least ten to fifteen thousand pounds, quite possibly a lot more.

And, as my NHS brother points out, "If anything had gone wrong with a private op, they'd have thrown you back to the NHS so fast you'd have broken the sound barrier." 

The eye surgery would have cost six to eight thousand pounds, plus extra fees for consultancy -- so that's a rough estimate of twenty-thousand pounds. In reality, it could easily have been a lot more.

I would have struggled, really struggled, to afford that. If I could have managed it at all.

The NHS, folks. The 'jewel in Labour's crown.' The finest achievement of Socialism, upholding the ideal that medical care shouldn't be reserved for the rich while the poor get pain and disability.

In recent years, Tories and Lib-Dems have taken to trying to claim some credit for the NHS, by claiming that it wasn't the Labour Party's idea, that the notion of the NHS was being discussed by 'all parties' back in the 1930s and 40s.

And, true, it was. They talked about it. They discussed it. They talked about it some more...Twenty or thirty years of blether.

The results of all that Tory and Lib-Dem blether? A big, fat nothing. They did nothing.

 As soon as they came to power, the Labour Party created the NHS. And all those Tories who'd 'discussed it'? -- They voted against it.

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